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Recent advances in automation of haematology analysers have significantly shortened turn-around-times for reporting leukocyte differential and count in the peripheral blood. Due to the introduction of improved flagging rates, the amount of microscopic peripheral blood slide reviews can be minimised.1 Having access to an enormous amount of data, one has to find the balance between productivity and clinical quality. Reliable automated blood cell characterisation and quantification remain challenging in pathological samples, whereas slide reviews due to unnecessary flagging should be avoided in normal samples. An important feature of the automated haematology cell counters is their ability to identify and quantify immature granulocytes (IG) in a peripheral blood sample.
Recently, the Sysmex XN series was introduced and its performance was evaluated.2 It provides the possibility to automatically count the IG in the peripheral blood. After applying a specific lysing agent (Lysercell WDF), the IG are measured in the WDF channel and differentiation is made based on granularity (side scatter) and nucleic acid content (side fluorescence by the Fluorocell WDF reagent). The IG cluster is found right above the neutrophil cluster in the biparametric histogram side scatter/fluorescence. The IG fraction includes promyelocytes, myelocytes and metamyelocytes (blasts and band cells are not included). In the present study, …